When I was young and considering my career, analyzing numbers was never even a blip on my radar screen. I wanted to find a profession that allowed me to work directly with people and improve their lives in some capacity. For this reason, I went into nursing and have never looked back. Caring for patients is at the core of nursing and it is why I love the profession.
Over the years, however, I have come to realize that numbers are the driving force behind my work in global health.
Numbers highlight the problem: there is a dire shortage of 7.2 million doctors, nurses, and midwives worldwide, according to the World Health Organization. In Malawi, where there is only one nurse or midwife for every 3,000 people, I have seen the challenges firsthand. To provide some context, in the United States there is one nurse or midwife for every 100 people. The current lack of nursing faculty in Malawi translates into large class sizes and turns student clinical supervision on the wards into a significant challenge. For example, at one Malawian nursing school, there are 170 nursing students currently needing to complete their pediatric clinical rotation. These students are spread across the country at ten clinical sites and there are too few faculty to provide supervision. Every other week, faculty have been required to travel up to five hours each way to provide clinical supervision. It is all too frequent that students are left alone in the clinical setting.
As Deputy Chief Nursing Officer of Seed Global Health (Seed), I have the privilege of supporting US nurse educators to work alongside their colleagues in nursing schools in Malawi, Tanzania, and Uganda. They are fortifying faculty numbers and helping to educate the next generation of local nurses and nursing leaders. These US nurse educators serve as Global Health Service Partnership (GHSP) Volunteers through Seed’s joint program with the Peace Corps and US President’s Emergency Plan for AIDS Relief (PEPFAR).
These numbers – 7.2 million,one nurses or midwife per 3,000 people and so on – allow us to measure and track the scarcity in human resources for health (HRH) over time. However, what these numbers often fail to convey is the human side of healthcare. Embodied within each of these statistics is a story about a child struggling from malnutrition, a woman experiencing childbirth complications, and a parent suffering from chronic diseases, all of whom are not getting the health care they need and deserve. The global scarcity of health care workers means that situations like these are happening multiple times in multiple places every single day. Multiplied by days, weeks, and months, the situation is seemingly too much to bear. Witnessing the impact on individuals, while recognizing the magnitude on a global scale, underscores the immediate need to bolster HRH.
However, there are numbers that offer hope. Last year’s class of 31 GHSP physician and nurse educators taught 85 courses to over 2,800 medical and nursing students, hospital staff, post-grads and fellows across the three partner countries. Volunteers like Matt Cerchie, a pediatric nurse specialist, Linda Jacobsen, a Certified Nurse Midwife, and Kelly Lippi, a Family Nurse Practitioner, helped equip these 2,800 learners with augmented clinical knowledge and skills. These volunteers added strength in numbers, taught their students how to provide quality healthcare, and through example, showed how to advocate for the child struggling with malnutrition, the woman experiencing childbirth complications, and the parent suffering from a chronic disease. Additionally, these 2,800 learners will go on to teach their new skills and knowledge to others, thereby having a multiplier effect. Investing in the education of health professionals in countries of greatest need is critical to combating the HRH shortage on a global scale and giving patients access to nurses and doctors who can provide quality care where and when they need it.
Similar to the famous African proverb, “It takes a village to raise a child,” it takes working closely with partners across all sectors – ministries of health and education, nursing and medical teaching institutions, and hospital staff and leaders – to strengthen health systems and improve health outcomes. It is through these public-private partnerships and developing sustainable, strategic approaches that we are striving to help make an impact in Malawi, Tanzania, and Uganda.
In recognition of International Nurses Day this year, I want to extend my gratitude to our partners who are committed to working with us, side by side, investing in strengthening nursing education through GHSP. To our students, local faculty, GHSP educators, partner government agencies, supporters, and more broadly, to all those working to make the shortage of 7.2 million merely a memory, thank you.